Economic, Social And Clinical Evaluations Of Diabetes Self Management Program At Universiti Sains Malaysia Health Center : Comparison Between Structured And Less Structured Educational Programs [RC660. H126 2008 f rb].

Kes-kes penyakit diabetes mellitus (DM) di dunia meningkat dengan banyaknya masa kini. Tambahan lagi, banyak komplikasi yang serius boleh berlaku akibat penyakit DM dan ini boleh memberi kesan negatif ke atas kualiti hidup individu serta meningkatkan beban ekonomi negara. Diabetes mellitus is increasing tremendously in the world. In addition, many serious complications could result from diabetes which would affect on the quality of life and would increase the economical burden in the country

Endoscopic ultrasound-guided tissue acquisition of pancreatic masses

Endoscopic ultrasound (EUS) has assumed an increasing role in the management of pancreaticobiliary disease over the past 2 decades but its impact is particularly evident in the management of pancreatic masses. EUS helps improve patients′ outcomes by enhancing tumor detection and staging while providing safe and reliable tissue diagnosis. This review provides an evidence-based approach to the use of EUS for the diagnosis of pancreatic cancer, its staging, and for the determination of resectability compared to other imaging modalities. We will focus on techniques specific to obtaining tissue from solid pancreatic masses and will review best practices in EUS-guided tissue acquisition

EUS-guided celiac plexus interventions in pancreatic cancer pain: An update and controversies for the endosonographer

Patients with pancreatic cancer (pancreatic ductal adenocarcinoma [PDAC]) can develop abdominal pain that can be debilitating. Celiac plexus neurolysis (CPN) is a chemical ablation of the celiac plexus that can be used to treat pain caused by pancreatic malignancy. It can be performed by an anterior or posterior approach, and also can be done percutaneously or under guidance of transabdominal ultrasound, computed tomography, intra-operatively or most recently under linear endoscopic ultrasound (EUS) guidance (EUS-CPN). EUS is well-suited for identification of the celiac plexus due to the close proximity of the gastric wall to the origin of the celiac artery. EUS-CPN is now widely practiced, and different EUS approaches have been developed in order to improve the efficacy of this technique. Our objective is to review the use of EUS-CPN in PDAC, including a description of different techniques, review of its efficacy, predictors of pain response, and describe its limitations and safety, as well as new developments

Importance of Financial Analysis for Published Financial Information to Predict the Stocks Behavior (Case study-ASE –Industrial Sector-Jordan)

This study aimed to identify the dimensions of the financial analysis and its advantages and how to benefit from it; in predicting stock prices by testing group of financial ratios and find a model quantitatively can be relied upon to predict the price per share of the industrial sector in the Amman Stock Exchange in order to help investors make rational decisions when they the investment process. To achieve this purpose has been tested three financial ratios for a sample of 30 companies listed their shares in the financial market, where data has been relying on published financial statements for its annual information. These ratios have been analyzed using the method of statistical known as a multiple regression to find the best model for the industrial sector of the financial market, which includes group of ratios (Many Variables) of Finance in which they can predict the price of stock in companies listed on the Amman Stock Exchange by this classification. Has been reached model for the industry where it appeared that the industry was affected by several variables affect the share price of this sector is the ratio of market value to book value and the percentage of the book value per ordinary share and the study concluded that it can rely on a set of financial ratios for each of the sectors (classified by the Palestine Securities Exchange) to predict the price of the arrow, study also recommended increased attention to the financial statements and transparency in the preparation and disclosure of the data and prepared according to international accounting standards, and it can an investor rely on financial analysis of the financial statements when making investment decisions. Keywords: Capital Asset Pricing Model (CAP.M), General Accounting Accepted Principle (GAAP), Earnings per Share (EPS), Book Value of share, Market Value of share, Stock Price

Role of endoscopic ultrasound fine-needle aspiration evaluating adrenal gland enlargement or mass

AIM: To report the clinical impact of adrenal endoscopic ultrasound fine-needle aspiration (EUS-FNA) in the evaluation of patients with adrenal gland enlargement or mass. METHODS: In a retrospective single-center case-series, patients undergoing EUS-FNA of either adrenal gland from 1997-2011 in our tertiary care center were included. Medical records were reviewed and results of EUS, cytology, adrenal size change on follow-up imaging ≥ 6 mo after EUS and any repeat EUS or surgery were abstracted. A lesion was considered benign if: (1) EUS-FNA cytology was benign and the lesion remained < 1 cm from its original size on follow-up computed tomography (CT), magnetic resonance imaging or repeat EUS ≥ 6 mo after EUS-FNA; or (2) subsequent adrenalectomy and surgical pathology was benign. RESULTS: Ninety-four patients had left (n = 90) and/or right (n = 5) adrenal EUS-FNA without adverse events. EUS indications included: cancer staging or suspected recurrence (n = 31), pancreatic (n = 20), mediastinal (n = 10), adrenal (n = 7), lung (n = 7) mass or other indication (n = 19). Diagnoses after adrenal EUS-FNA included metastatic lung (n = 10), esophageal (n= 5), colon (n = 2), or other cancer (n = 8); benign primary adrenal mass or benign tissue (n = 60); or was non-diagnostic (n = 9). Available follow-up confirmed a benign lesion in 5/9 non-diagnostic aspirates and 32/60 benign aspirates. Four of the 60 benign aspirates were later confirmed as malignant by repeat biopsy, follow-up CT, or adrenalectomy. Adrenal EUS-FNA diagnosed metastatic cancer in 24, and ruled out metastasis in 10 patients. For the diagnosis of malignancy, EUS-FNA of either adrenal had sensitivity, specificity, positive predictive value and negative predictive value of 86%, 97%, 96% and 89%, respectively. CONCLUSION: Adrenal gland EUS-FNA is safe, minimally invasive and a sensitive technique with significant impact in the management of adrenal gland mass or enlargement

Pancreatic hydatid cyst diagnosed on EUS-guided FNA

A 22-year-old woman presented with abdominal pain. Abdominal CT scan demonstrated a mass lesion in the pancreatic body (Fig. 1A). There was no lesion in the liver on CT scan (Fig. 1B). EUS showed a 50- × 35-mm cystic mass lesion containing numerous floating serpentine-like linear structures (Fig. 2; Video 1, available online at www.VideoGIE.org). EUS-guided FNA was performed with a 22-gauge needle